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Individual

EILEEN BETH LIEBLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
538 BROADHOLLOW RD STE 202, MELVILLE, NY 11747-3668
(631) 385-7780
Mailing address
763 PAT DR, WEST ISLIP, NY 11795-3541
(516) 233-0882

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
174400000X
Specialist

Other

Enumeration date
11/28/2017
Last updated
04/25/2018
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